肾康注射液联合前列地尔治疗糖尿病肾病的荟萃分析

目的:探究肾康注射液联合前列地尔治疗糖尿病肾病的有效性及安全性,为临床用药提供统计学证据。方法:计算机检索cochrane,Pubmed,Embase,CBM,万方数据库,维普和知网,筛选文献,录入数据,通过Cochrane风险评估工具对文献进行质量的评估,用Rev Man5.3进行统计分析,得出结论。结果:在降低24 h蛋白尿方面,观察组疗效优于对照组(MD:-0.22,95%IC[-0.44,-0.01])。在降低血肌酐(Scr)、血尿素氮(BUN)方面,观察组疗效也更好(Scr MD:-11.87,95%IC[-13.11,-10.63];BUN MD:-2.11,95%IC[-2.44,-1.78])。通过亚组分析发现在大体上,随着原有Scr、BUN基础值的水平增高,观察组治疗降低Scr、BUN优势更明显。结论:肾康注射液联合前列地尔在治疗糖尿病肾病优于单用前列地尔,且肾功能较差时,效果更显著。

Meta Analysis of Shenkang Injection Combined with Alprostadil in the Treatment of Diabetic Nephropathy

Objective:The meta-analysis aims to evaluate the effectiveness and safety of adding Shen Kang Injection to alprostadil.Methods:By searching the MEDLINE,Cochrane Library,EMBASE,Sino Med,Wanfang,Chinese National Knowledge Infrastructure and VIP databases and other ways,some articles are fitted into the meta-analysis which meets the selecting criterions.Perform the meta-analysis by using Review Manager 5.3.Results:The meta-analysis included nine randomized controlled trials(RCT).Comparisons of patients before and after treatment with alprostadil plus Shen Kang Injection or alprostadil alone revealed that alprostadil plus Shen Kang Injection resulted in significantly greater reductions in 24-hour urinary total protein(UTP)levels than alprostadil alone(MD:-0.22,95%IC[-0.44,-0.01]).Alprostadil plus Shen Kang Injection resulted is in significantly greater reductions in Scr and BUN comparing to ACEI/ARB alone(Scr MD:-11.87,95%IC[-13.11,-10.63];BUN MD:-2.11,95%IC[-2.44,-1.78]).And ACEI/ARB plus TG does better with higher baseline values.Conclusion:In patients with DN,adding Shen Kang Injection to alprostadil significantly lowered both 24 h UTP,Scr and BUN,particularly after higher baseline values.Therefore,adding Shen Kang Injection to alprostadil may improve the treatment of patients with DN.